Soft-tissue bone interface: how do attachments of muscles, tendons, and ligaments change during growth? A light microscopic study.

This study addressed the problem of how soft structures maintain approximately the same relative positional relationships during long bone growth. Attachments of the popliteus muscle, semitendinosus tendon, medial collateral knee ligament, and extensor retinaculum were examined histologically in rabbits, aged 2-60 days, to determine the manner in which soft structures attached to long bones during growth. Soft structures inserted principally into fibrous periosteum or perichondrium in the age range studied. However, an extensive collagen fiber framework within the cellular periosteum and perichondrium, present by at least 2 days of age, linked the fibrous periosteum or perichondrium to subjacent bone or cartilage. Maturation of soft tissue-bone interfaces was viewed from two related perspectives. The first stressed temporal patterning of cartilage and bone differentiation. The second emphasized incorporation of attachments of soft structures into bone and cartilage matrices during growth and remodeling. Differentiation and remodeling of bone and cartilage varied not only with age, but also between regions of attachment of single muscles and ligaments. Insertion regions were characterized by the presence of coarse-fibered periosteal bone and chondroid bone, both morphologically intermediate between fibrocartilage and lamellar bone. These results provide evidence that periosteal attachments, characterizing the soft-tissue bone interface, are a necessary structural prerequisite for compensatory movement and invariance of the relative positions of muscles, tendons, and ligaments during long bone growth.